25 year old, low test, please give advice on my bloodwork

Ever since graduating college and entering the grind, my libido has sucked for sure. I attested this to the stress and reduced sleep that I encountered on my first 1.5 years working full time. About 6 months ago I started a new job and thought everything would improve. Less stress, more sleep, better diet, no commute. Yet in actual fact about 3-4 months I started getting real fatigued in the day, and couldn't concentrate at work, bad memory, as well as signs of reduced test like lack of morning wood, lack of sexual thoughts etc. I'm in a long term relationship, so obvs sex isn't the same thing after 4.5 years, but i'd still expect to feel lust when I see hotties on the street!! Also I love lifting but I was beginning to have to drag myself to the gym, and while I still tend to hit my strength numbers, I leave the gym feeling run down and tired rather then pumped and high, like I used to. Even though I keep workouts to 45mins-1 hour.

Also I tend to sweat at night alot, and for a long time have been unable to sleep through the night without waking around 3-4am to piss, regardless of if I restrict fluid intake before bed. I've had on and off groin pain for the last year, so am having an ultrasound on December 5th, to rule out varicoceles or anything else. Testicles definitely feel smaller then they used to be. I've never used AAS, PHs, or any hair loss or serious pharmaceuticals.

As you may know getting any bloodwork on the NHS here in the UK is a journey in its self, if I post up all my measures I would appreciate any comments or things to test next. I've begun to understand that focusing on test and test boosting itself this past year has been the wrong method. I currently suspect adrenal fatigue so am waiting the results of an ASI test. I eat mostly paleo and lift wendlers 5/3/1, 4 times a week, with a session of BJJ once per week. Sleep 8 hours a night in a dark room

Early October 2012
SHBG 39nmol/L (13.0 - 71.0) they measured this alone, without test, which was very annoying, but the nhs havent got a clue.

Late October 2012 (using no test boosters)
Testosterone 11.4 nmol/L (8.0-30.0) converts to 335ng/ml
LH 4.5 iu/L (1.0-9.0)
FSH 2.3 iu/L (1.0-9.0)
prolactin 201mu/L converts to 9.48 ng/ml range less than 550 mu/L or <25.84 ng/ml
Oestrodiol 76pmol/L converts to 20.7 pg/ml range less than 150pmol or 40.86ng/ml
(non sensitive, didn't realise they had this option, i was lucky to get anything though to be honest as docs dont understand the importance)

I've been lucky to get any bloodwork like this, after of course the first testo measure was in the normal range. This doc seems willing to listen to my requests for bloodwork if i can justify them, but he is leaving the surgery soon, so I want to make use of him while I still have the chance.

I'm thinking my elevated TSH is not optimal, so getting free t3 would be an idea? also blood ferritin seems on the lower end of the range, so a full iron panel? I'll be getting DHEA with my ASI test, but a blood serum level may be more accurate?

Urea measured high, they said i was probably dehydrated, but i'm a big water drinker, so should repeat this measure. Also ALP seems high, but the normal reference ranges for this lab are huge.

TSH 2.5 miu/L (0.5-6.0)
Free T4 16.0 pmol/L (10-25)
...
I'm thinking my elevated TSH is not optimal, so getting free t3 would be an idea? also blood ferritin seems on the lower end of the range, so a full iron panel? I'll be getting DHEA with my ASI test, but a blood serum level may be more accurate?

Urea measured high, they said i was probably dehydrated, but i'm a big water drinker, so should repeat this measure. Also ALP seems high, but the normal reference ranges for this lab are huge.

any suggestions i would appreciate

Your TSH isn't high enough that it'll raise eyebrows, but some might consider it to be sub-optimal, and a signal that your thyroid is struggling to put out enough T4.

Here's a quote from The Importance Of Achieving Youthful Blood Test Readings (at the Life Extension Foundation.... I can't post the link yet because I don't have enough posts. Just look it up.)

"A review of published findings about TSH levels reveals that readings greater than 2.0 may indicate health problems relating to insufficient thyroid hormone output. One study showed that individuals with TSH values greater than 2.0 have an increased risk of developing clinically significant thyroid deficiency during the next 20 years (Vanderpump 1995). Other studies show that TSH values greater than 1.9 indicate risk of autoimmune disease of the thyroid gland (Hak 2000)."

When I get my thyroid bloodwork done, I get at least 6 tests:
1) TSH (which gives me an indication of how hard my thyroid gland is struggling to produce thyroid hormone)
2) Total T4 (which gives me an indication of how much total output my thyroid is producing; i.e., is it functioning well)
3) Total T3 (which gives me an indication of how well my body is converting T4 to T3).
4) Free T3 (which gives me an indication of how much T3 my body has to "make stuff happen" .... T3 is the active thyroid hormone and is supposed to be important for almost every cell in your body)
5) TPO/thyroperoxidase-antibody test (to see if there's an autoimmune attack on my thyroid. Autoimmune thyroid disease is a common cause of hypothyroidism, so when a person has sub-optimal thyroid numbers, this might be good to check)
6) Thyroglobulin Antibody/TgAb (another lab test to check for autoimmune thyroid issues)

Originally Posted by acidvoodoo

also blood ferritin seems on the lower end of the range, so a full iron panel?

Ferritin is one of those things that most people don't want too high or too low. If you read through some forums and articles at running/jogging websites (runners sometimes suffer from iron loss), you'll sometimes hear people with symptoms of fatigue, and when they run labs then find a really low ferritin level.... like under 20 ng/ml. For a male, that would be considered really low. If it were me, I'm not sure that I'd worry about a ferritin of 60 ng/ml.

That said, if you want to know more about ferritin, you should look up Dr. Mariano's post about "lab pointers." He suggests an optimal ferritin of about 150 for men.

You can also learn about excess iron by searching for the "Hemochromatosis Diagnosis Algorithm" at ironoverload dot org. Notice at the bottom they suggests a full iron panel to diagnose iron problems: Serum iron, serum ferritin, TIBC, Transferrin Saturation %.

Originally Posted by acidvoodoo

I'll be getting DHEA with my ASI test, but a blood serum level may be more accurate?

There are differences of opinion on this. Having said that, you will be able to find lots of alternative MDs, integrative medicine doctors, and anti-aging docs that prefer the saliva tests because they're easy to do at home for the 4x diurnal rhythm. Lots of sources suggests that this rhythm is very important and can help diagnose potential HPA dysfunction.

Originally Posted by acidvoodoo

Urea measured high, they said i was probably dehydrated, but i'm a big water drinker, so should repeat this measure. Also ALP seems high, but the normal reference ranges for this lab are huge.

i've had my salivary results back indication some strange dhea thing going on. any input on this? seems i have a huge pool of DHEA, that is not being used to build cortisol or testosterone, yet seems happily to go to estrogen!!

Got a Docs appointment on friday, my last one with this guy before he leaves the practice. I plan to make use of this and at least get as many measurements as possible to work with and figure out how to best optimize everything

I'm going to ask fora full thyroid panel, although the local labs here do not offer free t3 but only total t3, hopefully can still be of some use to figure out if i'm converting properly.

Also a full iron panel, as I have seem many instances of bloodwork where ferritin is normal yet other markers abnormal.

After the saliva test, I feel I should request estradiol ultra sensitive, just in case this is actual abnormal. And while i'm at in, repeat test, LH, and FSH, so see where these sit on repeat.

Finally, A blood measure of DHEAs, cortisol, and progesterone, to assess adrenal function bloodwise in the AM.

My GP listened to my concerns but decided to run no more blood work and reffered to onto the endos, which could take 2 months. So in the meantime i'm trying to address adrenal issues with adrenal support supplements. Enhance digestion with the right foods/digestive enzymes/probiotics, and improve estrogen metabolism with DIM.

Ultrasound came back all clear so i suppose with no structural issues leaves me open to potentially responding to low dose clomid

My GP listened to my concerns but decided to run no more blood work and reffered to onto the endos, which could take 2 months. So in the meantime i'm trying to address adrenal issues with adrenal support supplements. Enhance digestion with the right foods/digestive enzymes/probiotics, and improve estrogen metabolism with DIM.Ultrasound came back all clear so i suppose with no structural issues leaves me open to potentially responding to low dose clomidwould love matrix or mr TTs input on this?

One should not have to suffer 2 months to "see how you respond" me while you QOL is going the Shintz Creek with out a paddle. Where are you located? I have colleagues all over the world who be more willing to help.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

I am based in northern England like some of the other UK posters here. Have considered an integrative medicine consult but these are few and far between in the UK

I have Doctor who I am working on developing relationships in London who is an endocronologist who just ran a bunch of labs I suggest on a guy I am working with in london..I will know in a few weeks. I am just feeling him out now. So far seems to be working out good. How he responds to the testing results may be a different story. As long as I can get the results I need, its all good.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Got a Docs appointment on friday, my last one with this guy before he leaves the practice. I plan to make use of this and at least get as many measurements as possible to work with and figure out how to best optimize everything

I'm going to ask fora full thyroid panel, although the local labs here do not offer free t3 but only total t3, hopefully can still be of some use to figure out if i'm converting properly.

Also a full iron panel, as I have seem many instances of bloodwork where ferritin is normal yet other markers abnormal.

After the saliva test, I feel I should request estradiol ultra sensitive, just in case this is actual abnormal. And while i'm at in, repeat test, LH, and FSH, so see where these sit on repeat.

Finally, A blood measure of DHEAs, cortisol, and progesterone, to assess adrenal function bloodwise in the AM.

Also I was thinking of repeating ALP, with GGT, and Urea?

YOU HAVE A PERFECT PLAN... If it is high E2, a little AROMASIN works like magic.
(if you were in the USA, and using LABCORP for the E2 test, you would not want to order the ultra sensative test, the cheaper E2 test is more accurate.)

I've had a 4 point salivary cortisol test back, which is 3 months since my last one. I used geneva this time, as they seem more reliable and easier to compare to other results worldwide. My previous test using UK based androbalance, showed very high DHEA and depressed cortisol. Its hard to draw comparisons, but my new test definetly looks better, so all my lifestyle changes and supplements hopefully contributed. This was a typical monday, and i skipped the eveing gym session that day to not affect the evening cortisol

So overall cortisol is worst at around 5pm, which may corroborate why I still feel kinda fatigued going into the gym. Also, DHEA seems like it could be better, however I'm waiting to get a bloodtest for that, i'm still awaiting my Endo appointment. Fatigue could be getting caused by thyroid or blood sugar. I've been trying carb back loading to improve my insuilin sensitivity.

I feel like may be pregnenolone steal could be going on? which this panel would not show. So cortisol could be good but sex hormones still not getting the substrates needed. I've ordered MLM pregnenolone which ill give a try at 50mg a day. Will hold off DHEA until I have some bloodwork

Dhea being low is an indicator of immune issues or.possible.thyroid imbalance.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

My thyroid panel results are in from Genova. I'm pretty surprised at some of the numbers to be fair, high t3, highish reverse t3, TSH is still high despite all of this. To note, i'd been taking NOW thyroid energy for a few weeks prior, so the tyrosine may have been helping with conversion, but doesn't explain the high TSH.

Symptoms are still general malaise, low energy, brain fog, low mood, slow digestion or constipation if i'm not carefull with getting enough fiber, cold feet and sometimes hands, low libido even though no ED problems if i get into it. I have the energy to workout but dont feel amazing afterwards or anything. You'll see my adrenal test a month ago looked good so it shouldn't be adrenals causing the high TSH? The report indicates subclinical hypothyroidism, although says possible causes of higher TSH could be liver related?

Before i saw this report i was thinking of trying to push my doc for a trial of t4 to get my TSH down, clearly i'm not a bad converter, but no idea what would happen to my RT3.

My thyroid panel results are in from Genova. I'm pretty surprised at some of the numbers to be fair, high t3, highish reverse t3, TSH is still high despite all of this. To note, i'd been taking NOW thyroid energy for a few weeks prior, so the tyrosine may have been helping with conversion, but doesn't explain the high TSH.Symptoms are still general malaise, low energy, brain fog, low mood, slow digestion or constipation if i'm not carefull with getting enough fiber, cold feet and sometimes hands, low libido even though no ED problems if i get into it. I have the energy to workout but dont feel amazing afterwards or anything. You'll see my adrenal test a month ago looked good so it shouldn't be adrenals causing the high TSH? The report indicates subclinical hypothyroidism, although says possible causes of higher TSH could be liver related?Before i saw this report i was thinking of trying to push my doc for a trial of t4 to get my TSH down, clearly i'm not a bad converter, but no idea what would happen to my RT3.Total T4 97.6 [58 - 154 nmol/L]TSH 3.24 [0.4 - 4.0 miu/L]Free T4 14.9 [10 - 22 pmol/L]Free T3 5.62 [2.8 - 6.5 pmol/L]FT4:FT3 ratio 2.7 [2.0 -4.5]Reverse T3 0.47 [0.14 - 0.48 pmol/mL]Thyroglobulin antibodies - Less than 20 [optimal less than 35]Peroxidase antibodies Less than 10 [optimal less than 30]

This is commonly seen in secondary hypothyroidism due to adrenal insufficency or low ferritin levels, or toxicity where mitochondrion are not responding to t3 because they are jammed up with sludge.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

would secondary hypothyroidism not mean a poor TSH response in regards to low T3/T4? Is TSH driven more by Ft3 or Ft4? I'm not sure how to interpret RT3, does everyone "have" Rt3, so long as you're in range it isn't woeth worrying about?

if I was to trial exogenous thyroid hormone, would straight T4 or dessicted thyroid have more of an impact based on my labs do you think?

Looks like further Live testing and a stool analysis are on the cards now

would secondary hypothyroidism not mean a poor TSH response in regards to low T3/T4? Is TSH driven more by Ft3 or Ft4? I'm not sure how to interpret RT3, does everyone "have" Rt3, so long as you're in range it isn't woeth worrying about?

if I was to trial exogenous thyroid hormone, would straight T4 or dessicted thyroid have more of an impact based on my labs do you think?

Looks like further Live testing and a stool analysis are on the cards now

Rt3 is.symptom of the cause. without addressing adrenals you are asking for.more.problems.

stool sample only.use gi effect from metametrix which I.recommend for all cases followed.by 23andme and.detailed blood work then.nutreval as last resort.test. Depends on persons budget what you test.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Have put off any notion of Thyroid hormone supplementation, I will work on providing the right nutrients etc.

My Metametrix Gi effects has now been sent off, hopefully it will provide some valuable insight.

Matrix, you have cited examples of dealing with people who have nutrient deficiencies or metal toxicity that when corrected improved their T levels and overall symptoms? Would the Geneva "nutrient and toxic elemental analysis" bloodtest be a good starting point to look into these. The Nutraeval is way out of my budget but I want to still attempt to gain some insight on areas I have not looked into.

Which food allergy test do you tend to find greatest results from? Seems Genova has many. Also you talk about Mitochondriol sludge, is this is regards to the metals toxicity? How would you assess the mitochondria?

Please continue updating this thread. I am tracking blood test results and will consider posting my concerns online. I do not see anything severe but would like to feel better without caffeine/coffee. I'm thinking I have adrenal insufficiency but could have a digestive bug.

Please continue updating this thread. I am tracking blood test results and will consider posting my concerns online. I do not see anything severe but would like to feel better without caffeine/coffee. I'm thinking I have adrenal insufficiency but could have a digestive bug.

I order about 20-30 nutrevals and 10-20 Gi effects kits every few weeks for people.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Matrix, i've had my GI effects panel back. Will attach the report when I have time, but to summerise the findings it would seem:

Results:

I will attach the full report but i'll summerise what i've picked up based on reading the metametrix interpretive guide. I'm open to thoughts on all of this. MY symptoms aren't life threatening i'm just sick of feeling like i'm running at half mast despite seemingly being "healthy"

Preveotella SP is the highest obligate anaerobe. MM suggests this could be a sign of an oral/throat infection

Lactbacillus is top of the range. Bifidobacter sp. is mid range when this should be highest according to MM. E coli is towards the lower end.

I have yeast/fungi / taxonomy unavailable, at 3+

I have parasite present taxonomy unavailable, oh joys!

SCFA is on the lower end and Butyrate is marked as Low

Fecal SigA is just above the lowest part of the range

Thinking I should try and bring the yeast down with nystatin (as the sensitivity indicates this stopped the growth), then rotate some natural antifungals that were marked as sensitive, whist supplementing probiotics and saccamyces boulardi. Then I should attempt to bring down the gut inflammation

i'm thinking now, what If i just run a course of Nystatin. It seems to have low side effects, i've sensitive to it, and the UK docs will probably be willing to prescribe it as its relatively cheap. I'm not sure how long a standard course is. My test said the fungi is sensitive to it.

Then i'll rotate 3 of the natural herbs. I've ordered, black walnut, olive leaf extract, and cats claw. Again i'll rotate these, but not sure on doses or for how long people rotate them. 3 weeks each?

Throughout i'll take jarrowdophilius and sacchomyces boulardi to try and fill the void.

Also i'll try and move to a more low sugar/low inflammation diet, which i'm planning to do soon anyway to cut fat for summer.

Then I retest in 3 months and see where things are at. Won't worry about the PPTU unavailable for now

Nysatin back.fires, yeast adapts to quickly making them more resistant to.kill
have to clear parasites first along with doing a hellova lot more which most doctors never even address..why people continue to have issues.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

Doc has presribed me diflucan. He didn't really have a clue and was looking stuff up in his tatty book. He only prescribe 50mg per day for a week, which seems a very low dose, but hopefully combined with natural antifungals i may "feel something" enough to go back and ask to extend the treatment.

Doc has presribed me diflucan. He didn't really have a clue and was looking stuff up in his tatty book. He only prescribe 50mg per day for a week, which seems a very low dose, but hopefully combined with natural antifungals i may "feel something" enough to go back and ask to extend the treatment.

For parasite you need to do a broad spectrum sweep. Just because you.kill the parasite will not get rid of it because the eggs remain..diflucan is for yeast not parasites. If he is prescribe it for parasites.I.question his area of expertise. Kind of scary..

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

I cant seem to find concrete information that a parasite present taxonomy unavailable indicates treatment, MM tests for all the most pathogenic types which were negative. I think my goal is overall improving gut flora, reducing yeast, and seeing how that effects my digestion.

After a month of taking 12.5mg clomid per day, 12.5mg iodine, 400mg ashwagandha

Testosterone 40.4 nmol [7.6 - 31.4] I believe this converts to 1200

TSH 6.17 mIU/l [0.27 - 4.2] I believe this is an effect from all iodine?

free T4 16 pmol/l [12 - 22] This is where it always lies

So obviously the dose of clomid was too high. I dont think i experienced any negative sides, like the emotions people talk about, alot more night time wood, and for the first few weeks i think a bit more confidence and drive, and strength in the gym. However I expect as test shot way up my SHBG and E2 shot way up also so I didn't experience the benefits.

I have ceased clomid now as I finally have my appointment with an NHS endo almost 6 months from referral. Such a joke. But hopefully i'll get some good baseline bloodwork if nothing else. If i try clomid again i'll probably do 12.5mg sunday and thursday only.

I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

New labs in. I've been taking a herbal test booster, to see if it helped libido at all. Not so much. Thyroid looks good, as does Vit D, B12, iron levels, liver and kidney are all ok. TSH is for the first time ever under 2, and ft4 is highest its ever been so i'm going to continue the sea kelp/selenium.

I've decided that maybe I am in a chronic state of over training, so I am going to just lift 3 times a week alternating days at low weights to see if I recover. I'm about to start a new job so need the energy, and have decided to go back on clomid 12.5mg E3D for a boost. FSH is still below range, I do not understand why.

I'm still not convinced i don't have an underlying gut infection after my last time, so i have resubbited a sample to metametrix Gi effects. If any yeast or parasites come back this time i will go after them aggresively.

If anyone has any thoughts on the below labs, such as the iron labs or ferritin, let me know.

These could be more comprehensive but in the UK its just so damn hard/expensive.